Provider Information for 1295146157
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ISHMEL CERISIER
Sex: Female
NPI: 1295146157
Last Updated: 2015-02-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1295146157 | ||||||||||||
| Enumeration Date | 2014-05-14 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3544 EDGEWATER DR ORLANDO, FL 32804-2922 United States Phone: 407-291-8009 | Fax:140-777-0550 | ||||||||||||
| Primary Practice Address | 3544 EDGEWATER DR ORLANDO, FL 32804-2922 United States Phone: 407-291-8009 | Fax:140-777-0550 | ||||||||||||
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